The difference between first-level social security and third-level social security

Legal analysis: (1) principle of medical treatment First-class insured: seek medical treatment in any designated medical institution in the city. Second-class insured persons: outpatients seek medical treatment in the binding community health center, inpatient departments seek medical treatment in any designated medical institutions in the city, and outpatients seek medical treatment in designated medical institutions for serious illness.

Third-level insured persons: outpatients seek medical treatment in the binding social health center, and inpatients and outpatients seek medical treatment in prescribed medical institutions for serious illness. (2) General outpatient treatment Class I enrollment: Personal account is used to pay the medical expenses within the scope of the insured's general outpatient medical insurance catalogue. Community health center basic medical expenses personal account to pay 70%, the overall fund to pay 30% in accordance with the provisions. Second-level insured/third-level insured: drugs belonging to Class A and Class B are paid by the community outpatient co-ordination fund according to the proportion of 80% and 60% respectively; 90% of the single diagnosis and treatment or medical materials belonging to the medical insurance catalogue shall be paid by the community outpatient co-ordination fund, but the maximum payment amount shall not exceed 120 yuan; The total outpatient medical expenses paid by the community outpatient co-ordination fund to each second-grade and third-grade insured within a medical insurance year shall not exceed 1000 yuan.

(3) Hospitalization

First-class insured: 95% or 90% of the basic medical expenses incurred in hospitalization and supplementary medical expenses above the deductible line shall be paid according to the regulations. Second-level insured/third-level insured: you can be hospitalized in the settlement hospital bound to the social rehabilitation center, or you can be referred to the designated hospital through the settlement hospital. The reimbursement rates of basic medical expenses and local supplementary medical expenses above the hospitalization deductible line are: 85% for first-class hospitals, 80% for second-class hospitals and 75% for third-class hospitals.

The difference between the first grade and the second grade of social security is that the social security payment grade is divided into four grades: the lowest grade (40%), the first grade (60%), the second grade (80%) and the third grade (100%). The first file is paid according to 60% of the average wage payment base of last year, and the second file is paid according to 80% of the average wage payment base of last year. The higher the level, the more you get.

Legal basis: People's Republic of China (PRC) Social Insurance Law.

Article 1 This Law is formulated in accordance with the Constitution for the purpose of adjusting the social insurance relationship, safeguarding citizens' legitimate rights and interests in participating in social insurance and enjoying social insurance benefits, enabling citizens to enjoy the fruits of development and promoting social harmony and stability.

Article 2 The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to receive material assistance from the state and society in accordance with the law in case of old age, illness, industrial injury, unemployment and maternity.

Article 3 The social insurance system adheres to the principles of wide coverage, basic protection, multi-level and sustainability, and the level of social insurance should be compatible with the level of economic and social development.

Article 4 Employers and individuals who pay social insurance premiums according to law in People's Republic of China (PRC) have the right to inquire about payment records and personal rights and interests records, and ask social insurance agencies to provide social insurance consultation and other related services.

Individuals enjoy social insurance benefits according to law and have the right to supervise the payment of their own units.

Fifth people's governments at or above the county level shall incorporate social insurance into the national economic and social development plan.

The state raises social insurance funds through multiple channels. People's governments at or above the county level shall give necessary financial support to social insurance. The state supports social insurance through preferential tax policies.

Article 6 The State exercises strict supervision over social insurance funds. The State Council and the people's governments of provinces, autonomous regions and municipalities directly under the Central Government shall establish and improve the supervision and management system of social insurance funds to ensure the safe and effective operation of social insurance funds. People's governments at or above the county level shall take measures to encourage and support all sectors of society to participate in the supervision of social insurance funds.

Article 7 The administrative department of social insurance in the State Council is responsible for the management of social insurance throughout the country, and other relevant departments in the State Council are responsible for the relevant social insurance work within their respective functions and duties.

The social insurance administrative department of the local people's government at or above the county level shall be responsible for the social insurance management within its administrative area, and other relevant departments of the local people's government at or above the county level shall be responsible for the relevant social insurance work within their respective functions and duties.

Eighth social insurance agencies to provide social insurance services, responsible for social insurance registration, personal rights and interests records, social insurance benefits payment and other work.

Article 9 Trade unions shall safeguard the legitimate rights and interests of employees according to law, and have the right to participate in the research on major social insurance issues, participate in the social insurance supervision committee, and supervise matters related to employees' social insurance rights and interests.